Diet

Vitamin B12 - Cobalamin

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General

Vitamin B12 (or Cobolamin) is a water soluble vitamin, which is mainly used in animal products how liver or fish occurs and which of the not manufacture human bodies themselves can. As it is for functions like Cell division and cell formation, Blood formation and also for that Nervous system and Cardiovascular system It is important that the intake of vitamin B12 through food is essential. Vegans in particular who completely refrain from consuming animal products often suffer from an increased risk for one Vitamin B12 deficiency.

Occurrence and structure

Neither plants nor animals can Vitamin B12 synthesize only microorganisms like them Intestines colonize, are able to do so. Vitamin B12 can be found in, among other things Liver, beef, fish (salmon, herring), cheese, milk or in eggs.

Of the Vitamin B12 requirement is approx. 2-3µg and is therefore rather low compared to the need for other vitamins. In pregnant women, the daily requirement is somewhat higher, around 4 µg.

For those interested in chemistry:

Vitamin B12 / Cobalamin is a complex molecule with Cobalt as a central atom. It contains one Corrin ring, consisting of four pyrrole rings (Tetrapyrrole), as well as a dimethylbenzimidazone. The cobalt atom can form six bonds. Five of these are already occupied within the molecule, but with one it can bind different groups, which it then - this is its function - transfers to different substrates.

By binding e.g. one Methyl radical (CH3) to its free binding site on Cobalt Cobalamin / Vitamin B12 can, for example, transfer such a group to other substrates. E.g. in the Remethylation (Reassembly of CH3) from homocysteine to methionine. It can also rearrange certain groups within a molecule, so it serves as a so-called Mutase.

This is how vitamin B12 works

Vitamin B12 is essential for many processes and functions in the human body. Vitamin B12 is needed in the following places in the body:

Cell division and cell formation: It is particularly important for blood formation.
Formation of hereditary substances: Here, vitamin B12 as a coenzyme plays an important biochemical role in the formation of hereditary substances DNA and RNA
Nervous system: Vitamin B12 is also required for the formation of myelin sheaths (fat cells that cover the nerve fibers). Studies have shown that people with permanently low vitamin B12 levels have an increased long-term risk of developing dementia or brain atrophy (brain shrinkage).
Cardiovascular system: This is where vitamin B12 has a protective effect. Due to its ability to break down the amino acid homocysteine, which is toxic for the human body, vitamin B12 has a protective effect on the cardiovascular system. Homocysteine can lead to the formation of arteriosclerosis in the body.

Deficiency of vitamin B12

Causes of Vitamin B12 Deficiency

Vitamin B12 deficiency is relatively common. Vitamin B12 naturally has a very long half-life, which means that a deficiency only appears after several years. As a rule, a slight vitamin B12 deficiency is therefore not noticeable. Only a longer or more severe deficiency then appears with symptoms. Reserves of vitamin B12, which are mainly found in liver, Heart muscles, Skeletal muscles and in brain Can be stored in the body without feeding for 2-3 years sufficient.

Then it would become one Vitamin B12 deficiency and its sequelae come.
Typical causes for a vitamin B12 deficiency

a Insufficient intake of vitamin B12 from food (for example with vegans) or over the intestines
Stomach disorders (can also lead to a reduced absorption of vitamin B12)
Medication
a chronic strong one Alcohol abuse

In order to understand why stomach diseases can lead to a vitamin B12 deficiency, it is important to familiarize yourself with your Admission process too busy. Vitamin B12 is used in Small intestine (terminal ileum) by means of a transport protein, the so-called Intrinsic factor, recorded. This Intrinsic factor is produced in the stomach by special stomach cells (Parietal cells) and then released into the small intestine, where it forms a complex with vitamin B12, which enables the absorption of vitamin B12. It comes now, because of one Gastric resection, one chronic gastric mucosal inflammation (gastritis) or one Autoimmune disease to a decreased education and a lack of Intrinsic factor, vitamin B12 can no longer be adequately absorbed by the body. The result is a vitamin B12 deficiency with its typical symptoms.

Also Small bowel resections and Small bowel disease how Celiac disease or Crohn's disease can lead to vitamin B12 absorption disorders.

Medication as the Proton pump inhibitor omeprazole and Pantoprazole have been shown to inhibit the formation of gastric acid, which, however, also plays an important role in the absorption of vitamin B12. Therefore, these drugs can also lead to a vitamin B12 deficiency in the long term.
Most often, however, suffer older people over 60 years a vitamin B12 deficiency. This often goes undetected. There is one with them age-related gastric or intestinal atrophy the cause.
Ultimately also have Pregnant women and chronically ill because of her Additional requirements in vitamin B12 an increased risk of a deficiency. They should therefore attach particular importance to a balanced diet.

Cancer as a cause of vitamin B-12 deficiency

For the absorption of vitamin B12 in the small intestine are enzymes and Transport proteins necessary, which are formed in the stomach. Vitamin B12 has to go to the so-called "Intrinsic Factor" bound to be absorbed in the small intestine.

Patients who have had a gastrectomy for gastric cancer live without a stomach and can therefore no longer form an intrinsic factorwhich leads to vitamin B12 deficiency if this factor is not replaced.

Vitamin B12 is absorbed in the ileum, the end section of the small intestine. Patients who suffer from cancer because of this Section of intestine removed, also suffer from vitamin B12 deficiency if this is not corrected by vitamin B12 injections. In addition, patients with cancer are at greater risk of developing a vitamin B12 deficiency due to the chronic disease, which causes a higher metabolic rate, because they have a higher requirement.

The role of diet in vitamin B-12 deficiency

The human body's vitamin B12 stores are normal sufficient for two to three years. The human metabolism consumes every day 2 to 3 micrograms Vitamin B12, the recommendation of the German Society for Nutrition (DGE) therefore advocates 3 micrograms of vitamin B12 daily off.

Vitamin B12 is exclusively in animal products to find. People who are vegetarian or even strictly vegan are one high risk of deficiency exposed to vitamin B12.

Vitamin B12 can be found in Meat fish and Eggs and in small quantities in milk and dairy products.

Offal have the highest vitamin B12 concentrations, especially liver, because most of the vitamin B12 is stored in the liver.

The recommended daily dose of 3 micrograms of vitamin B12 is contained in 3 eggs, 500ml whole milk, 150g cottage cheese, 100g camembert, 150g Edam cheese, 100g salmon or 100g beef. Offal contains more vitamin B12 than meat: just 5g veal liver or 10g veal kidney contain 3 micrograms of vitamin B12.

Symptoms of a vitamin B12 deficiency

The first symptoms that can be noticed with a vitamin B12 deficiency are skin manifestations. The mucous membranes around the throat and lips are often affected. Torn corners of the mouth or an inflamed and sore tongue can also be the first signs of a vitamin B12 deficiency.

Since vitamin B12 is essential for the blood formation system, the nervous system and for the cardiovascular system, symptoms of a vitamin B12 deficiency are mainly expressed in

an anemia (pernicious anemia)
an increased risk of atherosclerosis and heart attack
in psychological and neurological symptoms such as memory disorders, dementia and polyneuropathies (sensory disorders in hands and feet)

Other symptoms that can be associated with a vitamin B12 deficiency are:

Burning tongue due to atrophic inflammation of the tongue (Hunter glossitis)
dizziness
Loss of appetite
Weight loss
Gastrointestinal problems such as constipation or diarrhea
an increased susceptibility to infection

Learn about Diarrhea from vitamin B12.

A very strong deficiency in vitamin B12 can also lead to functional disorders in the spinal cord. This so-called funicular myelosis mostly affects older people. Typical symptoms of funicular myelosis are polyneuropathies with loss of vibration sensation and position sense, muscle weakness and paralysis, as well as brain changes (Encephalopathy) with cranial nerve failure.

Read more about this on our website: Vitamin B12 deficiency.

Symptoms of the eyes with vitamin B-12 deficiency

Vitamin B12 deficiency can lead to Hemorrhage in the retina and to Degeneration of the optic nerve to lead. The symptoms are various visual disturbances. It is possible that visual acuity may deteriorate or the visual field may be caused by scotomas (circular field losses) is restricted. About a third of the time, symptoms appear around the eyes before the lack of vitamin B12 causes other symptoms.

Symptoms on the hair with a vitamin B-12 deficiency

Vitamin B12 plays an important role in our health hair, Hair loss is a possible symptom of a vitamin B12 deficiency. The reason for this is that vitamin B12 is essential for that Formation of the genetic makeup our cells, the DNA, is needed. If there is a vitamin B12 deficiency, the formation of new cells is disturbed, the hair shaft is poorly nourished and regenerated more poorly, which is why Death of the hair follicle and thus to Hair loss leads.

The symptom of sweating in a vitamin B-12 deficiency

Is sweating not a typical symptom of vitamin B12 deficiency. However, vitamin B12 deficiency can increase too Anemia to lead. This in turn is caused by physical exertion shortness of breath and Palpitationswhich can be associated with increased sweating.

This sweating is therefore more indirectly caused by a vitamin B12 deficiency and does not occur at rest. Rather, increased sweating is a sign of you disturbed hormonal balance, for example thyroid hormones or female sex hormones during menopause. Straight increased sweating without physical exertion is a sign of a hormonal problem.

The symptom of tingling in people with vitamin B-12 deficiency

A deficiency in vitamin B12 can Sheath shrinkage in the spinal cord cause and to Peripheral nerve neuropathy to lead.

The degeneration of the spinal cord leads to Unsteadiness and motor failures. The peripheral neuropathy shows through painful discomfort on the hands and feet. Patients experience a tingling or felty sensation. It is possible that if you are vitamin B12 deficient, these symptoms will occur even without anemia.

Vitamin B12 test

To one Vitamin B 12 deficiency one should determine one Blood test undergo.

There are numerous tests. Some that require a blood test, others that can be done at home with urine. The best and most reliable is direct detection in the blood.
That would be mentioned here Holo TC test. This value is noticeable very early, so to speak, before the correct vitamin B12 deficiency has occurred. The best way to counteract this is here.

As a rule, however, only the Vitamin B12 concentration determined in the blood serum. This also fulfills its main purpose, namely to find out a vitamin B12 deficiency. A test for a vitamin B12 deficiency is no cash benefitunless the doctor suspects such a deficiency to be the most likely cause of the disease.

The Urine tests which meanwhile for the Domestic use are available for sale, but are not characterized by great reliability. You should switch to the general practitioner's blood test, which is more informative and based on which appropriate treatment can then be started.

Tablets / injections

In addition to injections, vitamin B12 can also be supplied through tablets.

There are numerous preparations containing vitamin B12 and must be carefully selected based on the causes. A vitamin B12 deficiency can be prevented by means of vitamin B12 injections, that is Syringes, or through Tablets be treated. Even if an overdose of vitamin B12 can rarely occur, care should be taken with the dosage. In general, a doctor should be consulted before starting to take vitamin B12.

There are generally two different dosage forms for vitamin B12 on the market. The "Methylcobalamin“Represents a form that also occurs in nature and that can be processed directly by the body. The far more common form, the "Cyanocobalamin“Is a cheaper, but artificially produced variant.

If you have a vitamin B12 deficiency, mainly because of insufficient intake from food, you can try a vitamin B12 supplement Capsule or tablet form to take in. The manufacturers of Doppelherz or Tetesept offer corresponding products here. The capsules should be taken once a day for a few months Tablets should be with approx. 250µg per day start and take it to a maximum 500µg / day increase.

If the vitamin B12 deficiency has arisen despite sufficient amounts of vitamins ingested through food, it is probably one Resorption disorder. By a gastritis or Alcohol abuse there is a reduced development of the Intrinsic factorswhich is responsible for the absorption of vitamin B12. In this case, it would make no sense to take vitamin B12 as a capsule, as the body would not be able to absorb the vitamin anyway. In this case, you have to take the vitamin through a syringe.
Usually a vitamin B12 injection is used once a month administered for a period of 4-6 months. Then he should too Vitamin B12 Levels be determined in the blood. It is also important to find out the cause of any vitamin B12 level and treat the root cause. At a injection of vitamin B12 should be a maximum 1000-1500µg vitamin B12 per week splash. The injection can be given in a muscle (e.g. on the buttocks) or subcutaneously (i.e. in the fat layer of the body, e.g. on the stomach). Medical laypeople should have a doctor explain at least once how the correct injection should be made. It is even better to have the injection carried out by the doctor or nurse.

Read more about this on our website: Vitamin B12 supplements

Side effects

A Overdose of vitamin B12 is normal not possible and Side effects very rare.
Due to its water-soluble effect, excess vitamin B12 can be excreted through the kidneys without complications.
If, due to a vitamin B12 injection, there are still elevated levels and thus an overdose, the only side effect is usually one harmless local allergic reactionwhich shows up as increased pimples or a slight reddening.

Vitamin B12 overdose

People who mainly deal with animal products feed, especially offal, red meat but also cheese and quark also have an increased supply of vitamin B12. During the day, the organism needs an amount of vitamin B12 7-10 micrograms.

If a person is under stress, if he has frequent episodes of illness or if he is pregnant, he needs more. Ingesting too much vitamin B12 is usually not bad.The body excretes the amount it does not need, just like the other vitamins that are ingested too much. A Overdosing is almost impossible. What is relevant, however, is that excess vitamin B12 excreted via the kidneys becomes. This is therefore burdened.
This is another exception Cyanocobolamine preparation which is broken down in the body into small amounts of cyanide. As a rule, this doesn't bother people much either.

Sometimes excessive intake of vitamin B12, Skin manifestations occur that one acne same. When not to be mastered Acne symptoms The vitamin B12 level should always be checked.

Despite the stated daily amount of vitamin B12 required, it is not entirely clear when, by definition, there is an overdose of the vitamin. In general, there is no need to worry about overdosing. With other vitamins, overdosing can also cause damage or at least the formation of bothersome kidney stones.

Normal values of vitamin B-12

The body's own vitamin B12 stores are usually sufficient for two to three years From the liver stores most of the vitamin B12 (up to 10mg), Further 2mg are outside the liver saved. The recommended daily intake for vitamin B12 is 3 micrograms. The normal vitamin B12 level in the blood serum is between 300-900 pg / ml.

Problem: with low or medium normal values, there may still be a deficiency in vitamin B12, which the serum test does not detect. They are more precise Holo-transcobalamin testwho at Transcobalamin (Transport protein for vitamin B12) measures bound vitamin B12, or the MMA test (Methylmalonic acid) in blood or urine. Methylmalonic acid is a Metabolic product of vitamin B12, the test provides information about how much vitamin B12 is actually metabolized and used by the body.

Vegan diet

Vitamin B12 can only get through bacteria which are produced in human or animal intestines live and decompose food there. Therefore, there are hardly any plant foods that contain vitamin B12. Although there is now and then the information that vitamin B12 is also present in algae, sauerkraut or brewer's yeast, this form of vitamin B12 cannot be sufficiently absorbed and used by the human body.

The majority of vitamin B12 is therefore absorbed with our daily food. With the selection of nutritional products, you can also contribute to a more or less balanced vitamin B12 balance in the body.
Most of the vitamin B12 is found in foods of animal origin. What should be mentioned here above all Offal like liver, kidney but also in general Red meat. Another, albeit not so rich, source of vitamin B12 are Dairy products, like cheese or curd.

While vegetarian While doing without red meat rich in vitamin B12, they still consume vitamin B12 through cheese and quark as well as milk.
At Vegans looks different. People who live strictly vegan completely do without products such as milk, cheese and eggs. This is why vegans in particular who completely avoid animal products often suffer from a vitamin B12 deficiency.

It is important to mention that a vitamin B12 deficiency is observed much more frequently, especially in young people, when following a vegan diet. While adults who live vegan tend to have a vitamin B12 deficiency, but do not necessarily have to have it, a vitamin B12 deficiency is very common in children with a vegan diet.
So it is important that Toddlers are not raised vegan, to prevent this. Parents who insist on raising their children meat-free should at least pay attention to a vegetarian diet instead of a vegan diet. Chronic vitamin B12 deficiency in children can cause neurological damage.

Nowadays there are special soy or rice drinks for vegans that contain vitamin B12, with which they can balance their vitamin B12 requirements. In addition, doctors also advise Take vitamin supplements and your Regularly check vitamin B12 levels in the blood.